If you’re a woman and you’re a diabetic, then you’ve probably heard at some point that if you should decide to become pregnant, it would be considered high risk. While that’s true, motherhood isn’t completely out of the question. Of course, there are several precautions you’ll need to take to ensure a safe and healthy pregnancy and delivery as there are many risks and complications that can occur, such as birth defects, premature birth, a miscarriage,and preeclampsia. One the best ways to prevent any of these complications is by keeping your blood glucose levels under control before, during and after your pregnancy.
“There are significant hormonal changes involved when a woman becomes pregnant – one result is an increase in blood sugar,” explains Dr. Mark Carter, who practices internal medicine in Phoenix, Arizona. “So, when a woman with diabetes becomes pregnant, they’re at increased risk of having uncontrolled blood sugar. When you’re pregnant and your blood sugar is not controlled, you’re at a much higher risk of developing complications both for you and the baby.”
When trying to become pregnant, it’s all about planning ahead, whether you have diabetes or not. Before trying to conceive, you should be making regular visits to the doctor to discuss any questions and/or concerns you may have, such as stopping any medications, taking prenatal vitamins, as well as establishing a healthy meal plan and how much weight is appropriate to gain.
“Your diet should consist largely of what you were eating before you were pregnant. You will often need more calories for the baby, but while you are eating for two, you shouldn’t double your calories,” Dr. Carter says. “Healthy food choices include lean chicken and fish, low-glycemic carbohydrates, such as brown rice and sweet potatoes, and plenty of vegetables. There are a few things you want to avoid while being pregnant, i.e., sushi, raw oysters, and under-cooked meat.”
In addition to maintaining a healthy diet, it’s important to remain or start becoming physically active, squeezing in at least 30 minutes of exercise a day for three to four days per week.
“Moderate exercise is encouraged … In general, you want to do low-impact exercises, such as yoga, walking, swimming and step-ups,” Dr. Carter says. “In the first trimester, you want to go for moderate activity. In the last trimester, you may find that those same exercises cause you to become short of breath and seem more difficult. That’s because as the uterus grows, it starts to affect how much your diaphragm moves.”
Your health care team should include a doctor and nurse who specialize in diabetes along with a registered dietician. If you take medication for high cholesterol, high blood pressure, or any other conditions, you’ll be advised to stop taking them. Furthermore, if you take insulin to control your blood glucose levels, you may be required to switch brands or adjust the dosage.
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“There some classes of medications you shouldn’t take when you’re pregnant,” Dr. Carter says. “Some medications can cause birth defects, such as certain cholesterol medications like statins, ACE-inhibitors used for blood pressure control and blood thinners like Coumadin. Even care with herbals is important. For example, red yeast rice acts a lot like statins and should be avoided as well.”
Like most new mothers, you should be able to breastfeed your baby, but as a result, you may need to increase your caloric intake and lower your insulin for several days. Additionally, you’ll be at a higher risk of low blood glucose levels if you’re breastfeeding. Your doctor and dietician will sit down with you and recommend what, when and how often you should be eating on a daily basis.
All in all, it’s possible for women who have diabetes to be able to have a safe and healthy pregnancy, just as long as they follow the necessary precautions. “If you have diabetes and are thinking about becoming pregnant, planning is important,” Dr. Carter advises. “Before you become pregnant, talk with your doctor about how well-controlled your blood glucose is and if it’s not, talk about how to get it optimally controlled … planning [will help] ensure a successful pregnancy and healthy child.”
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